What initial treatment is recommended for supraventricular tachycardia (SVT)?

In cases of supraventricular tachycardia (SVT), vasovagal maneuvers are often the first-line intervention. These maneuvers, such as the Valsalva maneuver or carotid sinus massage, can effectively stimulate the vagus nerve, which may help to slow down the heart rate and restore normal rhythm without the need for medication or more invasive procedures. This non-pharmacological approach is particularly appropriate in stable patients experiencing SVT, making it a safe and useful initial treatment option.

Antiarrhythmic medications are typically considered for patients who do not respond to vagal maneuvers or have recurrent episodes requiring ongoing management, but they are not usually the first step in acute situations. Synchronized cardioversion is reserved for cases where the patient is unstable or if the SVT is persistent and symptomatic; it is not the immediate action taken for stable SVT. Defibrillation is specifically indicated for life-threatening arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia, and it is not appropriate for SVT, which is generally not life-threatening if the patient is stable.